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Molecules (Basel, Switzerland) Jun 2023Drug abuse and addiction are major public health concerns, with millions of people worldwide affected by the negative consequences of drug use. To better understand this... (Review)
Review
AIM
Drug abuse and addiction are major public health concerns, with millions of people worldwide affected by the negative consequences of drug use. To better understand this complex issue, a review was conducted to examine the mechanisms of action and effects of drugs of abuse, including their acute and chronic effects, the symptoms of abstinence syndrome, as well as their cardiovascular impacts.
METHODS
The analyzed data were obtained after surveying an electronic database, namely PubMed, with no time limit, grey literature sources, and reference lists of relevant articles.
RESULTS
The review highlights the different categories of drugs of abuse, such as opioids, stimulants, depressants, hallucinogens, and cannabis, and discusses the specific ways that each drug affects the brain and body. Additionally, the review explores the short-term and long-term effects of drug abuse on the body and mind, including changes in brain structure and function, physical health problems, and mental health issues, such as depression and anxiety. In addition, the review explores the effects of drug abuse on cardiovascular health, focusing on electrocardiogram changes. Moreover, the analysis of relevant literature also highlighted possible genetic susceptibility in various addictions. Furthermore, the review delves into the withdrawal symptoms that occur when someone stops using drugs of abuse after a period of chronic use.
CONCLUSION
Overall, this review provides a comprehensive overview of the current state of knowledge on drug abuse and addiction. The findings of this review can inform the development of evidence-based prevention and intervention strategies to address this critical public health issue.
Topics: Humans; Substance-Related Disorders; Substance Withdrawal Syndrome; Hallucinogens; Analgesics, Opioid; Anxiety Disorders
PubMed: 37446631
DOI: 10.3390/molecules28134969 -
Current Neuropharmacology 2024This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four... (Review)
Review
This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of PTSD treatment includes a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to good treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame, often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research.
Topics: Humans; Stress Disorders, Post-Traumatic; Psychotropic Drugs; Treatment Outcome; Substance-Related Disorders; Brain
PubMed: 37132142
DOI: 10.2174/1570159X21666230428091433 -
Association between cannabis use disorder and schizophrenia stronger in young males than in females.Psychological Medicine Nov 2023Previous research suggests an increase in schizophrenia population attributable risk fraction (PARF) for cannabis use disorder (CUD). However, sex and age variations in...
BACKGROUND
Previous research suggests an increase in schizophrenia population attributable risk fraction (PARF) for cannabis use disorder (CUD). However, sex and age variations in CUD and schizophrenia suggest the importance of examining differences in PARFs in sex and age subgroups.
METHODS
We conducted a nationwide Danish register-based cohort study including all individuals aged 16-49 at some point during 1972-2021. CUD and schizophrenia status was obtained from the registers. Hazard ratios (HR), incidence risk ratios (IRR), and PARFs were estimated. Joinpoint analyses were applied to sex-specific PARFs.
RESULTS
We examined 6 907 859 individuals with 45 327 cases of incident schizophrenia during follow-up across 129 521 260 person-years. The overall adjusted HR (aHR) for CUD on schizophrenia was slightly higher among males (aHR = 2.42, 95% CI 2.33-2.52) than females (aHR = 2.02, 95% CI 1.89-2.17); however, among 16-20-year-olds, the adjusted IRR (aIRR) for males was more than twice that for females (males: aIRR = 3.84, 95% CI 3.43-4.29; females: aIRR = 1.81, 95% CI 1.53-2.15). During 1972-2021, the annual average percentage change in PARFs for CUD in schizophrenia incidence was 4.8 among males (95% CI 4.3-5.3; < 0.0001) and 3.2 among females (95% CI 2.5-3.8; < 0.0001). In 2021, among males, PARF was 15%; among females, it was around 4%.
CONCLUSIONS
Young males might be particularly susceptible to the effects of cannabis on schizophrenia. At a population level, assuming causality, one-fifth of cases of schizophrenia among young males might be prevented by averting CUD. Results highlight the importance of early detection and treatment of CUD and policy decisions regarding cannabis use and access, particularly for 16-25-year-olds.
Topics: Male; Humans; Female; Schizophrenia; Marijuana Abuse; Cohort Studies; Substance-Related Disorders; Cannabis
PubMed: 37140715
DOI: 10.1017/S0033291723000880 -
Ugeskrift For Laeger Oct 2023Studies indicate that cocaine abuse in Denmark is rising. The drug can damage the midface's nasal tissues, cartilage, and bone. Diagnosing the cocaine-induced midline... (Review)
Review
Studies indicate that cocaine abuse in Denmark is rising. The drug can damage the midface's nasal tissues, cartilage, and bone. Diagnosing the cocaine-induced midline destructive lesions condition is difficult as patients may not admit to drug use. Thus, this review finds that physicians should ask about cocaine abuse in younger patients who present with midline destructions of unknown origin. Mild symptoms are reversible with total abstinence, which is why it is important to involve addiction services early. Besides drug abstinence, comprehensive treatment involves assistance from GPs, physiatrists, rhinologists, and plastic surgeons.
Topics: Humans; Cocaine-Related Disorders; Nose; Cocaine; Substance-Related Disorders; Diagnosis, Differential
PubMed: 37874002
DOI: No ID Found -
Genes Sep 2023Substance use disorders (SUD), like many neuropsychiatric conditions, are a heterogeneous group of disorders with similar symptomatology but often different...
Substance use disorders (SUD), like many neuropsychiatric conditions, are a heterogeneous group of disorders with similar symptomatology but often different pathoetiology [...].
Topics: Humans; Substance-Related Disorders; Genomics
PubMed: 37761900
DOI: 10.3390/genes14091760 -
Biomedicine & Pharmacotherapy =... Jan 2024Drug addiction is a complex disease affected by numerous genetic and environmental factors. Brain regions in reward pathway, neuronal adaptations, genetic and epigenetic... (Review)
Review
Drug addiction is a complex disease affected by numerous genetic and environmental factors. Brain regions in reward pathway, neuronal adaptations, genetic and epigenetic interactions causing transcriptional enhancement or repression of multiple genes induce different addiction phenotypes for varying duration. Addictive drug use causes epigenetic alterations and similarly epigenetic changes induced by environment can promote addiction. Epigenetic mechanisms include DNA methylation and post-translational modifications like methylation, acetylation, phosphorylation, ubiquitylation, sumoylation, dopaminylation and crotonylation of histones, and ADP-ribosylation. Non-coding RNAs also induce epigenetic changes. This review discusses these above areas and stresses the need for exploring epidrugs as a treatment alternative and adjunct, considering the limited success of current addiction treatment strategies. Epigenome editing complexes have lately been effective in eukaryotic systems. Targeted DNA cleavage techniques such as CRISPR-Cas9 system, CRISPR-dCas9 complexes, transcription activator-like effector nucleases (TALENs) and zinc-finger nucleases (ZFNs) have been exploited as targeted DNA recognition or anchoring platforms, fused with epigenetic writer or eraser proteins and delivered by transfection or transduction methods. Efficacy of epidrugs is seen in various neuropsychiatric conditions and initial results in addiction treatment involving model organisms are remarkable. Epidrugs present a promising alternative treatment for addiction.
Topics: Humans; Epigenomics; Histones; DNA Methylation; Epigenesis, Genetic; Substance-Related Disorders
PubMed: 38043446
DOI: 10.1016/j.biopha.2023.115951 -
International Journal of Molecular... May 2024Dopamine is a key neurotransmitter involved in physiological processes such as motor control, motivation, reward, cognitive function, and maternal and reproductive... (Review)
Review
Dopamine is a key neurotransmitter involved in physiological processes such as motor control, motivation, reward, cognitive function, and maternal and reproductive behaviors. Therefore, dysfunctions of the dopaminergic system are related to a plethora of human diseases. Dopamine, via different circuitries implicated in compulsive behavior, reward, and habit formation, also represents a key player in substance use disorder and the formation and perpetuation of mechanisms leading to addiction. Here, we propose dopamine as a model not only of neurotransmission but also of neuromodulation capable of modifying neuronal architecture. Abuse of substances like methamphetamine, cocaine, and alcohol and their consumption over time can induce changes in neuronal activities. These modifications lead to synaptic plasticity and finally to morphological and functional changes, starting from maladaptive neuro-modulation and ending in neurodegeneration.
Topics: Humans; Dopamine; Animals; Substance-Related Disorders; Neuronal Plasticity; Synaptic Transmission
PubMed: 38791331
DOI: 10.3390/ijms25105293 -
Genes Nov 2023Trauma in childhood and adolescence has long-term negative consequences in brain development and behavior and increases the risk for psychiatric disorders. Among them,... (Review)
Review
Trauma in childhood and adolescence has long-term negative consequences in brain development and behavior and increases the risk for psychiatric disorders. Among them, post-traumatic stress disorder (PTSD) during adolescence illustrates the connection between trauma and substance misuse, as adolescents may utilize substances to cope with PTSD. Drug misuse may in turn lead to neuroadaptations in learning processes that facilitate the consolidation of traumatic memories that perpetuate PTSD. This reflects, apart from common genetic and epigenetic modifications, overlapping neurocircuitry engagement triggered by stress and drug misuse that includes structural and functional changes in limbic brain regions and the salience, default-mode, and frontoparietal networks. Effective strategies to prevent PTSD are needed to limit the negative consequences associated with the later development of a substance use disorder (SUD). In this review, we will examine the link between PTSD and SUDs, along with the resulting effects on memory, focusing on the connection between the development of an SUD in individuals who struggled with PTSD in adolescence. Neuroimaging has emerged as a powerful tool to provide insight into the brain mechanisms underlying the connection of PTSD in adolescence and the development of SUDs.
Topics: Humans; Adolescent; Stress Disorders, Post-Traumatic; Substance-Related Disorders; Brain; Neuroimaging; Drug Misuse
PubMed: 38136935
DOI: 10.3390/genes14122113 -
Zoological Research May 2024
Topics: Animals; Pain; Anesthesia; Neurosciences; Humans; Substance-Related Disorders
PubMed: 38766753
DOI: 10.24272/j.issn.2095-8137.2024.138 -
Brazilian Journal of Anesthesiology... 2023Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering,... (Review)
Review
Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering, transmission of disease, as well as the risk associated with impaired vigilance. Healthcare providers may be harmed by the physical and mental impact of their addictions. Healthcare systems are placed in jeopardy by the legal impact associated with illegal routes of drug release including sanction and financial liability and loss of public trust. Healthcare institutions have implemented many measures to reduce diversion from the perioperative area. These efforts include education, medical record surveillance, automated medication dispensing systems, urine drug testing, substance waste management systems, and drug diversion prevention teams. This narrative review evaluates strengths, weaknesses, and effectiveness of these systems and provides recommendations for leaders and care providers.
Topics: Humans; Anesthesiologists; Prescription Drug Diversion; Substance-Related Disorders; Health Personnel; Pain
PubMed: 37517585
DOI: 10.1016/j.bjane.2023.07.008